Retrospective case-cohort study on safety of amphotericin B versus liposomal amphotericin B for hematologi-cal diseases
Objective To compare the safety of conventional amphotericin B(C-AMB)versus liposomal amphotericin B(L-AMB)for hematological diseases by case-cohort study.Methods The clinical data of 595 cases of hematological diseases treated with C-AMB or L-AMB between 2016 and 2022 in the department of hematology of Tongji Hospital were collected and compared the difference of side effects between these two groups after matching patients'age and sex by propensity score matching analysis.Results There was no difference between C-AMB and L-AMB in the duration of treatment and in the in-cidence of drug withdrawal owing to either treatment success or treatment failure.And there was no difference between C-AMB and L-AMB in the incidence of drug withdrawal caused by hypokalemia,liver damage,and kidney damage.The differ-ence between patients treated with C-AMB and patients treated with L-AMB in the incidence of renal damage and the inci-dence of hypokalemia was not statistical significantly.The key factor affecting amphotericin B-induced nephrotoxicity and hy-pokalemia was the increasing maximum daily dose of amphotericin B.Conclusion C-AMB is still a safe and effective drug that is worthy of clinical use,especially for patients of hematological diseases with poor economic conditions,who need em-pirical therapy or pre-emptive therapy.